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NEW YORK (CNNMoney) -- Forget designer strollers and organic baby formula, just providing a child with the basics has become more than most parents can afford.
The cost of raising a child from birth to age 18 for a middle-income, two-parent family averaged $226,920 last year (not including college), according to the U.S. Department of Agriculture. That's up nearly 40% -- or more than $60,000 -- from 10 years ago. Just one year of spending on a child can cost up to $13,830 in 2010, compared to $9,860 a decade ago.
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"Everything is more expensive and each family makes its own set of trade-offs," said Ellen Galinsky, president of the Families and Work Institute in New York. "Many parents are working longer hours, or another job, and they are giving up time at home. It's a complete catch-22."
From buying groceries to paying for gas, every major expense associated with raising a child has climbed significantly over the past decade, said Mark Lino, a senior economist at the USDA.
Food prices, in particular, have weighed on parents' budgets as rising demand for commodities like corn and wheat, along with other factors such as rising oil prices, drought and floods, have made even a box of cereal a pricey proposition.
Another notable increase has been the cost of transportation, which soared as a result of rising gas prices. Between 2000 and 2010, consumers paid an average of 85% more per gallon at the pump, according to AAA.
The battered economy has also taken a toll, of course. Many employers scaled back or even did away with medical coverage in recent years, leaving many families to cover that bill, said Lino. At the same time, costs for doctors visits, medications and other health services also climbed. As a result, health care costs for families with children rose 58% over the decade, he said.
All of this comes at a time when incomes are shrinking and unemployment is near an all-time high. Over the past decade, median household income have fallen 7%, according to a recent report from the Census Bureau.
The child care crunch
The early years are among the toughest for parents who must find a way to afford all of those costs, plus child care.
"It takes half of my paycheck to pay for my child care -- you start to feel like, Is this even worth it?" said Anna Aasen, a mother of two from Roseburg, Ore.
Although housing generally represents a family's largest expense, putting more than one child in day care tips the scales.
The anti-baby boom: Why the U.S. birth rate keeps falling
In 2010, the cost of putting two children in child care exceeded the median annual rent payments in every single state, according to a recent report by the National Association of Child Care Resource & Referral Agencies, or NACCRRA.
"It defies logic," said Linda Smith, NACCRRA's executive director. As more families are priced out of licensed child care services, the health and safety of those children are put in jeopardy, she said.
For Stephanie Serafini, 38, licensed day care for her two children comprises about 30% of her $39,000 annual income. Serafini pays a particularly high rate for care because her oldest son was diagnosed with Asperger's and ADHD.

It is by far Serafini's largest monthly expense, but also the one with the least flexibility. "Other bills don't get paid," she admitted. "If you don't have day care you don't work."
For many parents, choosing to work and pay for child care is often a difficult trade off when they might otherwise stay home.
"The sad truth is, when you weigh the cost of child care and the cost of my wife driving back and forth to work it comes out to an extra $2 to $3 an hour," Ben Hammond, 31, said of his wife's decision to return to the workforce after their second son was born. "But we can't really live without that."
Saving strategies for parents
"[Parents] are overwhelmed," said Lule Demississie, managing director of retirement and investment products at TD Ameritrade.
The first step is to tackle the rising cost of raising a child is to start saving, she said. Stash some cash in a regular brokerage account, which will likely offer a higher return than traditional savings but can also be easily accessed to cover impending expenses, recommended Demississie.
"If you have expenses a year or two out, there are ways you can save that are more efficient than your savings account," she advised.
For longer-term needs, Demississie suggested finding tax deferred ways to save for the major bills, like employer-sponsored flexible spending accounts for health care and child care and Coverdells for education expenses or 529 plans for college, which allow you to save pre-tax dollars.
Ginger Ewing, a financial adviser with Ameriprise Financial, says new parents often ask her about saving for college but she urges them to think about more pressing needs like day care first. "If you have to choose," she said, "start there."
Poverty rate rises in America
Ewing says it's those immediate needs that are often the most underestimated. She recommends holding at least $5,000 to $7,000 in a savings account or CD to cover the big expenditures that start even in the first year.
For those unable to set aside that kind of cash, Rita Cheng, another financial adviser, strongly advises couples to start slowly and do what they can.
"If all you can do is save $50 a month, that's fine. It's not the amount, it's the action that matters and sticking to it," she said.

Huntsville Hospital's three solar-powered electric cars are used to make deliveries, check on locked doors and pick up employees in the medical district. (The Huntsville Times/Dave Dieter)
HUNTSVILLE, Alabama - Yes, they do turn heads when people see them cruising around the medical district.
No, they don't have golf bags on the back, though they're often referred to as a "souped-up golf cart."
The three solar-powered cars that Huntsville Hospital uses for a variety of purposes are the hospital's way to reduce effects on the environment and to stay on the cutting edge of new technology.
But, they still look like souped-up golf carts.
"We get a lot of looks and a lot of questions about it," said Frank Garcia, the hospital's utility systems manager.
The hospital bought three of the GEMs (Global Electric Motorcars) last year to replace two gasoline-fueled cars in its fleet.
"We thought, 'What the heck, let's try some electric cars,'" Garcia said.
The hospital paid about $13,000 for each GEM and spent about $25,000 on the solar equipment, batteries and chargers.
Instead of paying Huntsville Utilities for electricity to recharge the vehicles, the hospital installed 12 solar panels to produce the power needed to run the cars.
The solar panels are at the top of the parking deck on Madison Street and are hooked up to eight batteries, which store the power until the vehicles are recharged.
The car's battery can fully recharge in four hours and run a full eight-hour shift, or about 30 miles, on a full charge, Garcia said.
"It doesn't really have a solar panel on it," Garcia said of the solar-powered car. "It's charged by solar panels."
The cars are used by the hospital's security and maintenance divisions for various tasks. Security workers drive the cars for such things as to lock doors, pick up employees and make deliveries. Plant operations workers use them maintaining the hospital's grounds.
The hospital limits the use of the cars to the medical district, though they do go to the Medical Mall at Governors Drive and the Memorial Parkway.
The cars, which can hold four people, are street legal. But, with a top speed of about 26 mph, the hospital keeps them off Governors Drive.
"We're afraid they would get run over," Garcia said.
Garcia said the hospital is on the list to buy Nissan's Leaf electric car. The Leaf would allow the hospital to use it in a larger area, such as trips to its affiliate hospitals in Athens, Decatur and Sheffield, he said.
Zero emissions from the electric cars is an important aspect of protecting the environment, but so, too, is eliminating the disposal of transmission fluid, engine oil and antifreeze, Garcia said.
The solar-powered electric cars also offers the hospital options during an emergency such after the April 27 tornadoes. When the city was without power for several days causing gasoline pumps to not work, the solar panels continued to provide power and the solar cars kept rolling, Garcia said.
The cars and solar charging stations also give the hospital an opportunity to "stay ahead of the curve" in running the hospital, he said. They are "an entry-level opportunity to learn and experiment with this type of technology," Garcia said. "We believe that this type of technology will continue to improve and will be a part of the future."